At HETT, HTN took the opportunity to sit down for a chat with Owen Powell, ICT director at Central and North West London NHS Foundation Trust (CNWL), during which Owen shared his experience of the trust’s move to cloud infrastructure with the support of Rackspace Technology; his advice for other trusts embarking on or considering a similar undertaking; and what cloud means for healthcare and innovations in the future.
Central and North West London NHS Foundation Trust successfully migrated to cloud in 2020. In doing so, the trust has positioned itself to meet the future demands of NHS and new models of care, reducing complexity and improving security and scalability.
Moving to the cloud: advice for other trusts
Reflecting on CNWL’s experiences, Owen said that other trusts should make sure that they have considered every element of their organisation that will be impacted by the move to cloud.
“You need to know that your infrastructure suits cloud; if you are running too many legacy systems, for example, then it is going to be very costly and challenging to migrate over. Trusts should undertake an initial assessment to check whether their systems are ready for cloud, or whether there is preliminary work to be done to get them to that point.”
Another factor to take into consideration is what the cloud provider is offering, Owen continued. “That includes making sure that the provider can offer the assurances and accreditations the trust requires; that your cyber posture is in a fit state, and what they offer in terms of security.”
The third key consideration involves taking the time to examine the financial elements of migrating to the cloud, including the costs and the revenue model. “Trusts undertaking this journey need to be very comfortable with having their revenue models in place,” he stated.
Moving to cloud does require a “leap of faith”, Owen acknowledged; it requires NHS trusts to embark upon an extremely complex journey which involves moving highly personal data into somebody else’s care.
“I’ve had colleagues ask me: Owen, where do we even start? It’s absolutely a complicated process. But that’s where these key considerations come into it. Speak to the providers, do your assessments, do your discovery work. Once you’ve had your discussions and tested the viability of cloud migration, you can test the appetite internally around assurance and finance and the transition element.”
Ultimately, Owen said, his experience of migrating to the cloud “has been a very positive one. These elements I’ve mentioned are the key factors, and if you can check them off and cross those hurdles, I would tell them to go for it. Don’t think twice.”
Digital to fix, versus digital for the future
Presenting on CNWL’s journey to cloud for the HETT audience, Owen highlighted how the move to cloud has led the wider trust team to view digital and technology differently – from something that is there to provide a fix or patch up existing issues, to a dynamic tool to allow forward thinking and future innovation. In particular, Owen drew attention to the culture change at play here. So: how has cloud changed ways of working at CNWL?
“Over a period of time, people have got used to IT as being something that works,” Owen reflected. “There was a time when IT would be disruptive. There would be downtime, it would work slowly, we were dealing with old machines. Things wouldn’t work as well as they should. It can be a real annoyance, as we all know; we called it the stone in our shoe. Through our work around cloud and our other development work, we have managed to shake that stone free. People don’t have to think about IT now – it just works, it doesn’t have to cross their mind because it is not posing a challenge in their working day.”
This creates the space for conversations about the future, Owen continued. “Because we’re not tackling downtime issues or struggling to connect to a system, we can have those ‘what could we do with X’ or ‘what about Y’ conversations. We can read about AI in the news and consider how it could help us with our own productivity, because we’ve got the time to do that now; we’re not wasting energy by focusing our efforts on how to fix something simple that is frustrating our staff. We can have constructive conversations about innovation, and crucially, these conversations are now underpinned by a confidence that our day-to-day systems are going to work.
The NHS of the future: what does ‘good’ look like for cloud use?
For Owen, ‘good’ comes back to consistency. He raised the fact that there are 215 NHS trusts, all largely doing their own thing; some operating from the cloud, some utilising a mixture of cloud and on-premises infrastructure, and some working only with on-premises infrastructure. Servers have different makes, models and versions with widely varying numbers. There are different cyber postures across the NHS. Ultimately, he said, there is so much variation, and that comes hand-in-hand with huge complexity.
“In an ideal world, ‘good’ would look standardised; simplified; and unified. It would be managed and controlled with the same firewalls and the same branding, patching, assurance. As a whole NHS we would see the benefits I mentioned, that CNWL has seen come into play already – not having to worry about servers and data centres and air conditioning.”
The scale that would be necessitated to achieve this “can feel like a dream”, Owen acknowledged, “but if the NHS got there, it would be fantastic.”
He also noted the potential for benefits if the NHS could shift away from operating as lots of smaller organisations and move more towards a nationally mandated, nationally managed and nationally funded service. “I think the opportunity for unified working could offer a lot,” he said. “It would be expensive, there’s no doubt; but we have to ask ourselves what the long-term savings would look like.”
The impact on innovation
Owen commented on the rise of artificial intelligence and the current level of interest in this tech. “Cloud’s impact on this, in part, comes back to creating headspace, as I mentioned earlier,” he said. “My team have the headspace to think about what AI could offer, rather than spending their time fixing servers.
“But it’s also about knowing your data. If you’ve got your data well-organised, and you understand it and know where it is, you are in a better position to utilise that data for things like AI. You are dealing with known data; you understand its parameters. Ultimately, it is safer, and cloud has enabled you to trust that data because it has ensured a solid foundation for you.”
Working in partnership
CNWL and Rackspace Technology worked closely together in order to navigate the trust’s migration to the cloud. During his HETT presentation, Owen highlighted the cloud expertise that the Rackspace team brought to the experience. Is there anything in particular he learnt from the collaboration, and anything he believes Rackspace learnt from working with the trust?
“We’ve learnt a lot about hybrid cloud from Rackspace,” Owen said. “People talk about ‘the cloud’ but it’s not really a thing in itself. There are so many different types of clouds and there are different toolings within the cloud, and different cost benefits to each. So from Rackspace I would say that we have learnt that it isn’t one size fits all; and that the optimisation process for your own specific organisation is key.”
As for what Rackspace has learnt from CNWL, Owen said: “I think we have probably taught them patience! Healthcare is so complex and things can take a long time to process through all of our systems.”
A practical tip
To conclude, we asked Owen for the number one practical tip he would like to share with other trusts who might be at the start of a journey similar to the one CNWL has undertaken.
“Take your finance department out for a coffee!” Owen said. “Have a chat with them, sit them down, and tell them that you will work in partnership with them through the process in terms of the costing, the funding, the ongoing costs, the value proposition and the benefits. Make sure they know it’s a collaborative effort, and get them on side to help.”
Many thanks to Owen for taking the time to share his views.
For more information, please visit EMEA Healthcare Cloud IT Transformation | Rackspace Technology.
